foreign body obstruction

foreign body obstruction,

a disturbance in normal function or a pathologic condition caused by an object lodged in a body orifice, passage, or organ. Most cases occur in children who suddenly inhale or swallow a foreign object or insert it into a body opening. Large boluses of hastily eaten food frequently lodge in the esophagus, causing coughing, choking, and, if the airway is obstructed, asphyxia. Forceful blows to the victim's back between the shoulder blades or the Heimlich maneuver may dislodge the bolus. Esophageal foreign bodies usually produce an immediate reaction but occasionally result in a long asymptomatic period before signs of obstruction or infection are evident. Laryngeal foreign bodies usually cause hoarseness, wheezing, and dyspnea; a sharp object, such as a chicken bone, may perforate the larynx and cause swelling and infection. A foreign body in the trachea may cause wheezing, an audible slap, coughing, and dyspnea. A small object may become lodged in a bronchus, producing coughing, which is often followed by an asymptomatic period before signs of obstruction and inflammation appear. Needles and hairpins ingested by children often pass through the esophagus and stomach without incident but may become lodged at the turn of the duodenum and require removal by a magnetized nasogastric tube or by laparotomy. Laxatives are contraindicated, and if tenderness, rigidity, pain, nausea, or vomiting ensues, immediate surgery is necessary. Coins, marbles, and closed safety pins usually pass through the digestive tract without creating problems, but hairballs, vegetable fibers, or shellac concretions sometimes found in the stomach of emotionally disturbed or retarded patients may cause anorexia, nausea, and vomiting. Hairballs may be fragmented by an endoscope and removed by lavage; surgery may be required.